Hip Protectors

A hip protectors are underwear containing hard or soft pads on the outside of each hip/leg. They are designed to prevent hip fractures during a fall. (for more information on falls, click here)

hip prot

Most commonly used in elderly individuals who have a high risk of falls and hip fractures (ie. previous falls, osteoporosis). The elderly often develop a fear of falling that leads to avoiding physical activity which further compounds the problem as they de condition rapidly.

Most hip fractures follow an impact due to a fall. The protective pads are located over the trochanters of the hips (most common site of fracture) to absorb the impact like a crumple zone in a car..

Hip protectors are either the “crash helmet” or “energy-absorbing” type material. The “crash helmet type” distributes impacts into the surrounding soft tissue, while the “energy-absorbing type” is made of a compressible material and diminishes the force of impact. Both of these systems aim to reduce the focused force.

Several different commercially available hip protectors exist, such as the Safehip (Tytex A/S, Ikast, Denmark), the AHIP Protector (Astrotech, Vienna, Austria) and the KPH hip protector (HRA Pharma, Paris, France). Hip protectors have the advantage of having no significant adverse effects.

Clinical studies of their effectiveness have shown conflicting results, probably due to the variability in design, composition, fitting, compliance etc. Regardless of exact results, the argument behind their use is logical. Reduce the force going to the hip during a fall and this will reduce the chances of a hip fracture, bruising, pelvic fracture, coccyx fracture, spinal fracture. There is some suggestion that their use can lead to a reduced fear of falling if marketed to the Resident properly.

For the most appropriate type of Hip Protector for a Resident please see the Physiotherapist.

Research

A systematic review from 2006 found that that hip protectors are only marginally effective for preventing hip fracture among nursing home residents, and not effective among community dwelling elderly individuals. A recent randomized trial was discontinued because it failed to demonstrate any benefit. A Bayesian meta-analysis showed a decreased risk of hip fractures in elderly nursing home residents.

Also, acceptance and long-term compliance towards them is quite low, mainly because of discomfort, dislike of their appearance by the person wearing it, and disagreement about fracture risk. A recent study showed that hip protectors’ design and mechanical properties vary drastically among commercially available hip protectors.

  1. ^ abc Holzer, G; Holzer, LA (2007). “Hip protectors and prevention of hip fractures in older persons”. Geriatrics62 (8): 15–20. PMID 17668960.
  2. ^ Lauritzen, JB (1996). “Hip fractures: incidence, risk factors, energy absorption, and prevention”. Bone18 (1 Suppl): 65S–75S. doi:10.1016/8756-3282(95)00382-7. PMID 8717550.
  3. ^ Holzer, LA; Holzer, G (2007). “Design: A neglected factor in medicine”. McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students10 (1): 3. PMC 2323546. PMID 18523599.
  4. ^ Lin, JT; Lane, JM (2008). “Nonpharmacologic management of osteoporosis to minimize fracture risk”. Nature clinical practice. Rheumatology4 (1): 20–5. doi:10.1038/ncprheum0702. PMID 18172445.
  5. ^ abc Parker, MJ; Gillespie, WJ; Gillespie, LD (2006). “Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review”. BMJ (Clinical research ed.)332 (7541): 571–4. doi:10.1136/bmj.38753.375324.7C. PMC 1397761. PMID 16513687.
  6. ^ ab Kiel, DP; Magaziner, J; Zimmerman, S; Ball, L; Barton, BA; Brown, KM; Stone, JP; Dewkett, D et al. (2007). “et al.. Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial”. JAMA 298 (4): 413–22. doi:10.1001/jama.298.4.413. PMID 17652295.
  7. ^ Sawka, AM; Boulos, P; Beattie, K; Papaioannou, A; Gafni, A; Cranney, A; Hanley, DA; Adachi, JD et al. (2007). “Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis”. J Clin Epidemiol60 (4): 336–44. doi:10.1016/j.jclinepi.2006.07.006. PMID 17346606.
  8. ^ Patel, S; Ogunremi, L; Chinappen, U (2003). “Acceptability and compliance with hip protectors in community-dwelling women at high risk of hip fracture”. Rheumatology (Oxford, England)42 (6): 769–72. doi:10.1093/rheumatology/keg215. PMID 12730537.
  9. ^ Holzer, LA; Von Skrbensky, G; Holzer, G (2009). “Mechanical testing of different hip protectors according to a European Standard”. Injury40 (11): 1172–5. doi:10.1016/j.injury.2009.02.005. PMID 19524913.